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Medical costs comparison

Compare medical costs to reduce out-of-pocket expenses.

How out of pocket medical costs work in Australia

If you have Medicare, you have 2 options for receiving hospital treatment: public or private. In the public system, Medicare will generally pay all of your costs.

If you choose private hospital care, your costs can be covered in a few ways. Medicare will still pay some, but a private health fund can also cover some of your fees. If you don't have private health cover, then you'd need to pay for the entire private procedure. If you do have private hospital cover for your treatment, then there may still be out of pocket costs.

Compare medical costs across Australia

The table below compares some costs of common medical procedures in 5 different states. The data comes from Medical Costs Finder, a tool managed by the Department of Health and Aged Care. The data was last updated on 29 September 2023.

  • Typical specialists’ fees refers to the cost of specialists, assistant surgeons, and anaesthetists. It doesn't include hosptial fees, which are generally either mostly or fully covered by private health insurance funds.
  • Patients typically paid refers to the the median amount paid by the typical patient, after Medicare and Private Health insurance benefits were paid.
  • Patients typically paid refers to the the median amount paid by the typical patient, after Medicare and Private Health insurance benefits were paid.
  • % with no out-of-pocket costs refers to the proportion of partients that didn't have to pay any out of pocket costs.
Treatment% with no out-of-pocket costsTypical specialists’ feesPatients typically paid
Adenoid removal33%$1,500$810
Ankle replacement30%$5,700$1,500
Knee reconstruction28%$4,500$2,300
Knee arthroscopy45%$2,500$850
Breast biopsy41%$2,200$440
Breast reduction9%$11,000$8,600
Caesarean section (complex)43%$4,600$500
Caesarean section (no complications)51%$3,500$500
Cataract surgery69%$2,100$500
Gastric bandNANANA
Gastric bypass44%$3,900$1,100
Heart-related angiogram87%$1,900$60
Heart valve replacement (not TAVI)34%$15,000$510
Hip replacement (bilateral)22%$9,900$5,500
Hip replacement33%$5,300$1,100
Femoral or inguinal hernia repair53%$2,200$560
Knee replacement38%$5,200$1,100
Male contraception (e.g. vasectomy)46%$1,200$510
Total mastectomy (remove breast)50%$3,800$520
Patella stabilisation (stabilise the kneecap)35%$3,500$1,300
Prostatectomy (endoscopic)46%$3,400$820
Pterygium surgery58%$1,700$250
Removal of skin lesion52%$1,700$500
Retinal detachment repair - surgery54%$3,300$400
Rotator cuff repair32%$3,900$2,000
Shoulder replacement32%$6,000$2,500
Sinus surgery39%$3,400$840
Sleep studies99%$730$20
Sleeve gastrectomy (partial stomach removal)51%$3,200$880
Stress incontinence45%$3,000$1,500
Tonsillectomy with or without adenoidectomy (12 years of age and over)30%$2,100$1,300
Turbinectomy (remove small nasal bones)24%$1,800$860
Umbilical hernia repair57%$1,700$590
Vaginal delivery (no complications)70%$2,900$500
Vaginal delivery (complex)61%$3,600$500
Vaginal repair49%$3,300$680
Varicose veins53%$1,900$400
Wound debridement66%$1,700$380
Treatment% with no out-of-pocket costsTypical specialists’ feesPatients typically paid
Adenoid removal20%$1,100$400
Ankle replacement17%$4,400$560
Knee reconstruction16%$3,800$570
Knee arthroscopy26%$2,100$390
Breast biopsy20%$2,100$280
Breast reduction12%$9,400$7,200
Caesarean section (complex)38%$4,400$450
Caesarean section (no complications)35%$3,400$400
Cataract surgery30%$1,900$300
Gastric band28%$3,100$500
Gastric bypass21%$4,800$1,100
Heart-related angiogram85%$2,000$110
Heart valve replacement (not TAVI)27%$13,000$470
Hip replacement (bilateral)8%$10,000$5,500
Hip replacement18%$5,500$730
Femoral or inguinal hernia repair34%$1,800$280
Knee replacement20%$5,100$600
Male contraception (e.g. vasectomy)33%$980$200
Total mastectomy (remove breast)23%$4,200$500
Patella stabilisation (stabilise the kneecap)17%$3,200$520
Prostatectomy (endoscopic)32%$2,900$400
Pterygium surgery21%$1,700$270
Removal of skin lesion70%$1,500$250
Retinal detachment repair - surgery13%$3,500$250
Rotator cuff repair22%$3,300$520
Shoulder replacement21%$5,700$620
Sinus surgery27%$2,800$450
Sleep studies96%$730$10
Sleeve gastrectomy (partial stomach removal)35%$3,500$540
Stress incontinence29%$2,300$260
Tonsillectomy with or without adenoidectomy (12 years of age and over)21%$1,600$500
Turbinectomy (remove small nasal bones)20%$1,400$480
Umbilical hernia repair37%$1,400$270
Vaginal delivery (no complications)69%$2,800$350
Vaginal delivery (complex)45%$4,300$430
Vaginal repair25%$3,200$420
Varicose veins33%$2,100$300
Wound debridement53%$1,600$200
Treatment% with no out-of-pocket costsTypical specialists’ feesPatients typically paid
Adenoid removal23%$1,300$400
Ankle replacement13%$4,500$5,700
Knee reconstruction19%$4,100$1,000
Knee arthroscopy25%$2,300$650
Breast biopsy22%$2,500$700
Breast reduction7%$9,800$7,800
Caesarean section (complex)46%$4,800$500
Caesarean section (no complications)41%$3,600$500
Cataract surgery40%$2,100$450
Gastric bandNANANA
Gastric bypass19%$3,500$500
Heart-related angiogram64%$2,000$10
Heart valve replacement (not TAVI)32%$16,000$480
Hip replacement (bilateral)16%$8,400$2,400
Hip replacement19%$5,000$1,000
Femoral or inguinal hernia repair28%$2,100$500
Knee replacement22%$4,800$990
Male contraception (e.g. vasectomy)40%$1,200$440
Total mastectomy (remove breast)21%$4,200$800
Patella stabilisation (stabilise the kneecap)22%$3,300$900
Prostatectomy (endoscopic)26%$3,300$580
Pterygium surgery24%$1,800$450
Removal of skin lesion35%$1,800$500
Retinal detachment repair - surgery40%$4,000$630
Rotator cuff repair21%$3,400$890
Shoulder replacement16%$5,400$1,000
Sinus surgery25%$3,200$760
Sleep studies99%$730$10
Sleeve gastrectomy (partial stomach removal)17%$3,000$850
Stress incontinence16%$2,600$680
Tonsillectomy with or without adenoidectomy (12 years of age and over)22%$1,700$570
Turbinectomy (remove small nasal bones)26%$1,500$540
Umbilical hernia repair29%$1,700$500
Vaginal delivery (no complications)78%$2,900$300
Vaginal delivery (complex)55%$3,700$450
Vaginal repair30%$3,300$690
Varicose veins17%$2,300$880
Wound debridement37%$1,800$500
Treatment% with no out-of-pocket costsTypical specialists’ feesPatients typically paid
Adenoid removal44%$1,000$270
Ankle replacementNANANA
Knee reconstruction19%$3,500$280
Knee arthroscopy27%$1,900$190
Breast biopsy54%$2,300$150
Breast reduction9%$5,600$3,600
Caesarean section (complex)25%$5,000$300
Caesarean section (no complications)23%$3,400$250
Cataract surgery49%$1,900$300
Gastric bandNANANA
Gastric bypass12%$4,200$500
Heart-related angiogram92%$2,100$10
Heart valve replacement (not TAVI)50%$12,000$300
Hip replacement (bilateral)NANANA
Hip replacement28%$4,700$350
Femoral or inguinal hernia repair43%$1,600$200
Knee replacement30%$4,600$350
Male contraception (e.g. vasectomy)38%$880$150
Total mastectomy (remove breast)56%$4,000$210
Patella stabilisation (stabilise the kneecap)21%$2,700$240
Prostatectomy (endoscopic)47%$2,700$220
Pterygium surgery55%$1,900$500
Removal of skin lesion62%$1,400$250
Retinal detachment repair - surgeryNANANA
Rotator cuff repair30%$2,800$250
Shoulder replacement38%$4,800$300
Sinus surgery25%$3,100$500
Sleep studiesNANANA
Sleeve gastrectomy (partial stomach removal)15%$3,500$500
Stress incontinence14%$2,300$500
Tonsillectomy with or without adenoidectomy (12 years of age and over)19%$1,500$430
Turbinectomy (remove small nasal bones)30%$1,400$400
Umbilical hernia repair32%$1,300$150
Vaginal delivery (no complications)56%$2,900$250
Vaginal delivery (complex)45%$3,100$200
Vaginal repair39%$2,800$350
Varicose veins21%$1,600$160
Wound debridement66%$1,500$160
Treatment% with no out-of-pocket costsTypical specialists’ feesPatients typically paid
Adenoid removal49%$1,200$510
Ankle replacementNANANA
Knee reconstruction47%$3,500$470
Knee arthroscopy57%$2,000$450
Breast biopsy22%$2,700$560
Breast reduction6%$8,800$6,900
Caesarean section (complex)72%$4,900$440
Caesarean section (no complications)76%$3,400$280
Cataract surgery85%$1,700$110
Gastric bandNANANA
Gastric bypass76%$3,800$500
Heart-related angiogram92%$2,000$20
Heart valve replacement (not TAVI)26%$16,000$350
Hip replacement (bilateral)NANANA
Hip replacement55%$4,200$450
Femoral or inguinal hernia repair69%$1,800$300
Knee replacement55%$4,000$350
Male contraception (e.g. vasectomy)53%$1,100$470
Total mastectomy (remove breast)26%$3,600$500
Patella stabilisation (stabilise the kneecap)47%$2,800$350
Prostatectomy (endoscopic)49%$2,800$720
Pterygium surgery75%$1,500$210
Removal of skin lesion54%$1,500$260
Retinal detachment repair - surgeryNANANA
Rotator cuff repair58%$2,800$440
Shoulder replacement62%$4,400$300
Sinus surgery31%$2,800$500
Sleep studies99%$760$70
Sleeve gastrectomy (partial stomach removal)35%$6,300$4,000
Stress incontinence31%$2,400$1,200
Tonsillectomy with or without adenoidectomy (12 years of age and over)25%$1,500$550
Turbinectomy (remove small nasal bones)27%$1,500$530
Umbilical hernia repair69%$1,500$220
Vaginal delivery (no complications)83%$2,700$190
Vaginal delivery (complex)NANANA
Vaginal repair56%$3,300$870
Varicose veins64%$1,600$40
Wound debridement61%$1,700$460

Finder survey: How many Australians of different ages worry about being able to pay for medical bills?

Response75+ yrs65-74 yrs55-64 yrs45-54 yrs35-44 yrs25-34 yrs18-24 yrs
Source: Finder survey by Pure Profile of 1006 Australians, December 2023

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